A lot has been written, debated and blame assigned in the tragic case of the premature baby declared dead by doctors in Max Hospital, New Delhi who was later found to be alive by relatives on the way to perform last rites.
As per latest reports in the press, the hospital terminated the services of attending physicians Dr. A.P. Mehta and Dr. Vishal Gupta for not following the laid down procedure of performing an ECG prior to declaring the baby dead.
The baby eventually passed away in a Nursing Home at Pitampura on 6th December and the family has declared they would agitate till the guilty are punished. From the media reports it seems that there was an expert probe panel appointed by the government to investigate the case and also a police enquiry where the hospital was sent a questionnaire with 20 questions pertaining to the case.
I refrain from commenting on the merits and demerits of this individual case; but want to examine a key issue pertinent to this scenario.
Traditional media, social media and politicians have been rabid in condemning the hospital and the attending doctors and then corporate hospitals as a group and doctors as a profession citing the case.
My curiosity in the case pertained to just one aspect: the age of the “baby” or babies in this case as it was a twin pregnancy. I read through some randomly selected news items from leading media outlets like Times Now, NDTV, etc.
The NDTV article titled “Delhi Hospital That Declared Newborn Dead Fires 2 Doctors Amid Outrage” reported by Snigdha Basu, edited by Aditya Sharma | Updated: December 04, 2017 08:50 IST; says “On November 30, a 22-week pregnant woman gave birth to twins, of which the girl was still-born”.
The Times Now article titled “Max Hospital case: Newborn baby found ‘alive’ though declared dead, dies; father refuses to take body”; Updated: Dec 06, 2017 | 17:20 IST | Times Now Digital says at the first instance “Authorities at Max Healthcare released a letter on Wednesday, expressing their condolences over the baby’s demise. It said, “We just learnt of the sad demise of the 23-week preterm baby, who was on ventilator support”; and in a second instance citing says “As per the preliminary report by the panel, hospital authorities had not followed prescribed medical norms in dealing with a 22-week premature newborn baby”.
I checked on a third article, this time from The Hindu titled “Twin extreme preterm babies case: Delhi’s Max Hospital terminates services of two doctors” filed by Staff Reporter NEW DELHI, DECEMBER 04, 2017 08:46 IST and UPDATED: DECEMBER 04, 2017 15:30 IST which says “case pertains to the premature delivery (23 weeks/5 months) of twins last week and subsequent declaration of their death at the hospital at Shalimar Bagh in New Delhi”.
I went through articles from several other media outlets The Indian Express, First Post etc; most of which did not specify the age of the babies.
So why this excessive curiosity on the age of the babies. It is simple; at 22 weeks most health systems would consider the foetus to be unviable. In practice according to Born-Alive Infants Protection Act of 2002 of United States “doctors and nurses are advised not to resuscitate such persons with gestational age of 22 weeks or less, under 400 g weight, with anencephaly, or with a confirmed diagnosis of trisomy 13 or 18”. Are we surprised that the Americans already have a piece of legislation to handle precisely such cases; while our politicians seem to be more interested in creating empty sound bytes than study the issue scientifically.
It is well accepted that completion of 24 weeks is the viable age for premature babies and 22 weeks is unviable. Unfortunately the intermediate period of 23rd week seems to be a grey area of indecision; hence the convoluted allusion to Hamlet in the title of this piece.
It has become a norm for the media to quixotically charge at illusionary wind mills in most cases related to medical negligence. By no stretch of imagination am I alluding that the attending doctors or the hospital is not at fault in handling this particular case. That’s for the experts and the legal system to determine.
The anguish and pain of the parents of the babies tug at the hearts of everyone. It would break the heart of the strongest when still born children are handed over in polythene bags (why not the dignity of being wrapped in flannel cloth? Was the hospital cost cutting on that?). But journalists have the responsibility to present the perspectives from all the sides rather than writing up lopsided versions to cater to emotions and drama. That’s the job of the writers of mega serials of prime time television.
Not one of the stories I read through mentions the fact that the chance of survival of a foetus completing 22 weeks of gestation is minimal; or the extreme cost and effort required to keep these extremely premature babies alive.
If we take 30 seconds to google the topic, it will tell you this – Amillia Taylor the youngest case of premature survival in 2006 in Florida was born with a gestational date of 21 weeks and 6 days. The babies in the Max Hospital case are hardly a day or two older having entered their 23rd week.
It is very easy to register a case under Section 308 (attempt to commit culpable homicide) of the IPC against the attending doctors. They may be guilty of lapse of procedure and judgement or even callousness; but to accuse them of culpable homicide for failing to save an almost improbable life is stupidity.
Two of our most common phrases apt to this situation comes from a single poem by Alexander Pope titled “An Essay on Criticism”. And these phrases are “To err is human, to forgive divine” and “fools rush in where angels fear to tread”. Maybe our friends need to brush up on their Pope.